Our patient came from an endemic area where levels of arsenic are high in drinking water and had features of arsenical keratosis for past fifteen years along with metastatic testicular cancer at the time of presentation.

The cycling legend's battle against the dreaded disease started way back in 1996 when Armstrong, then an upcoming US rider, was diagnosed with late-stage metastatic testicular cancer that had spread to his abdomen, his lungs and his brain.

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